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General NPI Number Information
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NPI Number | 1235464256
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Entity Type | Individual
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Provider Name | SANDEEP KUMAR MD
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Gender | Male
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 221 LONGWOOD AVE BRIGHAM & WOMEN'S HOSPITAL
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City | BOSTON
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State | MA
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Zip | 02115-5804
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Country | US
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Telephone | 617-525-8254
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Fax | 617-264-5123
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Provider Business Mailing Address
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Address Line | 77 POND AVE APT # 1005
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City | BROOKLINE
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State | MA
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Zip | 02445-7141
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Country | US
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Telephone | 617-731-5605
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Fax | 617-264-5123
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 242655
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License Number State | MA
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